The trigemino-pupillary response in cluster headache

G. Micieli, C. Tassorelli, L. Ruiz, G. Sandrini, G. Nappi

Research output: Contribution to journalArticlepeer-review


Central impairment of the integrative neural systems controlling vegetative function and pain perception has been demonstrated in cluster headache (CH). Recently, we describe the human pupillary response (trigeminal reflex) to quantified (painless and painful) corneal stimulation with a combined neurophysiological and pharmacological technique. In this study, the trigeminal reflex was evaluated in 26 subjects with episodic cluster headache. During the active phase of the disease, on the side of the pain we observed reduced mydriasis to electrical stimuli with an intensity equal to the corneal reflex threshold, and on both sides to stimuli with intensity that equalled the pain threshold. No difference was found when amplitude of the miotic phase was compared in the different groups. These suggest disordered pupillary activation in response to pain, probably sympathetic in origin, which is bilateral, detectable also during the remission phase and which cannot be explained simply by the antidromic release of pain-related peptides.

Original languageEnglish
Pages (from-to)338-342
Number of pages5
Issue number5
Publication statusPublished - 1993


  • Central dysfunction
  • Cluster headache
  • Corneal stimulation
  • Pupil

ASJC Scopus subject areas

  • Clinical Neurology


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